EXPLANATORY NOTE OFFSHORE COMPONENTS IN ACCREDITED AUSTRALIAN PROGRAMS OF STUDY FOR REGISTERED NURSES AND MIDWIVES 1. PURPOSE This explanatory note has been prepared to assist education providers within Australia seeking to conduct a subject or a component of a subject in an accredited program of study offshore. This explanatory note does not apply to education providers submitting a program leading to endorsement as a nurse practitioner or registration as an enrolled nurse. Education providers must also comply with all relevant accreditation standards. 2. BACKGROUND ANMAC is responsible for the accreditation of all nursing and midwifery education providers and programs of study leading to registration and endorsement in Australia. The safety and quality of care provided to people in the health care system is reliant on nurses and midwives possessing the necessary knowledge, skills, attitudes and behaviours and developing their capacity for critical thinking and clinical judgment. This is achieved by ensuring national consistency and quality in nursing and midwifery education through a robust assessment process using contemporary accreditation standards. 3. APPLICATION This explanatory note applies to all education providers seeking accreditation of programs of study for registered nurses and/or midwives that offer an offshore component of the program. This may be theoretical and/or professional experience components of the program. A formal process of modification by ANMAC is required prior to the addition and implementation of offshore components in accredited programs that are listed as Approved Programs of Study on the Nursing and Midwifery Board of Australia website. For relevant documentation-please visit the ANMAC website. Note: This explanatory note does not apply to nurse practitioner and enrolled nurse programs of study as all components of these programs are required to be conducted within Australia.
4. RELEVANT DOCUMENTATION In addition to the relevant Accreditation Standards detailed in Section 3 this explanatory note should be read in conjunction with the Australian Qualifications Framework which may be accessed at AQF 2nd Edition January 2013 The following documents are relevant to this explanatory note: ANMAC Registered Nurse Accreditation Standards (2012) ANMAC Midwife Accreditation Standards (2014) ANMAC Enrolled Nurse Accreditation Standards (2017) ANMAC Registered Nurse Application Pack ANMAC Midwife Application Pack Australian Qualifications Framework January 2013 5. EXPLANATORY NOTE ANMAC supports in principle the opportunity for a student in an approved registered nursing or midwifery program of study to undertake a component of that study as an offshore experience. Undertaking a component of study offshore has the potential to enrich the student s practice through exposure to diverse cultural and educational experiences and to enhance a program of study through the development of mutually beneficial relationships between the Australian education provider and the offshore host organisation supporting the relevance of globalisation to nursing and internationalisation of nursing curricula. 1 2 3 4 5 The Registered Nurse Accreditation Standards (2012) require education providers to ensure that: Equivalence of theory or workplace experience gained outside Australia in terms of subject objectives, learning outcomes and assessment. Learning experiences undertaken outside Australia must not exceed one semester. The Midwife Accreditation Standards (2014) require education providers to ensure that: Equivalence of theory or workplace experience gained outside Australia in terms of subject objectives, learning outcomes and assessment. Learning experiences undertaken outside Australia must not exceed one fifth of the total program. If the program is shorter or longer than three years, the time the student spends offshore should be calculated on a pro rata basis. That is, no more than one sixth of a student s total program of study and no greater than one sixth of a student s total professional experience 1 Grant, E. and McKenna, L. (2003), International clinical placements for undergraduate students. Journal of Clinical Nursing, 12: 529 535. doi: 10.1046/j.1365-2702.2003.00717.x 2 Tuckett, A. and Crompton, P. (2014), Qualitative understanding of an international learning experience: What Australian undergraduate nurses and midwives said about a Cambodia placement? International Journal of Nursing Practice, 20: 135 141. doi: 10.1111/ijn.12142 3 Glass, N., Cochran, W. and Davidson, P. M. (2015), Editorial: Transformational experiences a key to improving global health: the role of the Peace Corps. Journal of Clinical Nursing, 24: 1149 1150. doi: 10.1111/jocn.12821 4 Charles, L., Maltby, H., Abrams, S., Shea, J., Brand, G., & Nicol, P. (2013). Expanding worldview: Australian nursing students' experience of cultural immersion in India. Contemporary nurse, 48(1), 67-75. 5 Lee, N. J. (2004). The impact of international experience on student nurses personal and professional development. International Nursing Review, 51(2), 113-122. Explanatory Note 2 of 5
hours may be undertaken in an offshore setting and be counted towards the student s qualification. EVIDENCE REQUIRED Accredited education providers of programs of study for registered nurse and midwifery students in Australia who elect to offer a component of the program offshore are required to submit to ANMAC the following evidence. 5.1 RATIONALE Education providers must articulate a clear rationale for the inclusion of the offshore component of study. It must be clearly stated whether the component is an observational, theoretical and /or a clinical experience. The intended learning outcomes of the study experience must be clearly outlined with the support for teaching, learning and assessment strategies that will be utilised in the offshore setting included. For all subjects where students have the opportunity to engage in either the theoretical, and or clinical component outside Australia, the education provider must demonstrate: Whether the subject is a core or elective subject in the program of study. How the subject of study relates to the philosophical and conceptual framework of the program. How equivalence between subjects has been determined (including the clinical component where applicable). Evidence of how the subject of study satisfied the relevant accreditation standards. In which part of the program the offshore component of study is undertaken and why demonstrating scaffolding of learning and appropriate preparation of students. The Registered Nurse Accreditation Standards (2012) and the Midwife Accreditation Standards (2014) require education providers to ensure that workplace practice experience is included towards the end of the program in Australia. This requirement also applies to other Standards still to be reviewed even if not explicitly stated. 5.2 CULTURAL AND PROFESSIONAL PREPARATION The education provider must demonstrate evidence of a robust selection process for students seeking to undertake a component of study offshore. The selection process must be based on the principles of equity, fairness and quality. The education provider must also demonstrate evidence of the processes for the cultural and professional preparation of students and academic staff prior to the offshore experience that is relevant and sensitive to the destination. The professional preparation must ensure that students have a sound understanding of the scope of practice for nurses and midwives in the host country. Examples of how professional preparation could be presented to students include workshops or self-directed study. Evidence of how students will demonstrate understanding of cultural and professional preparation should be submitted that includes but is not limited to: Host country culture, including appropriate dress and religious, social, communication and other cultural observances. Explanatory Note 3 of 5
Host country health service culture, scope of practice for the nurse or midwife and relevant regulatory requirements. 5.3 RISK MANAGEMENT STRATEGY The education provider must demonstrate evidence of a robust organisational risk management framework that clearly articulates processes for assessing and ensuring the safety of students and academic staff while offshore. This should include but is not limited to: Student and academic staff preparation prior to departure. Pre-departure health check and vaccination schedule. Department of Foreign Affairs and Trade (DFAT) advisories. Requirements for health and travel insurance. Indemnity in the context of clinical practice (This will vary depending on destination and should be clearly articulated, including evidence of any MOU s describing reciprocal arrangements in place). Pastoral support arrangements. Designated point of contact in both Australia and the host country in case of emergency; tested prior to departure. Personal safety awareness with a clear communication and decision-making pathway in the event of an emergency, up to and including evacuation procedures. 5.4 EQUIVALENCE AND ASSESSMENT Where the student receives credit for the offshore experience, either theoretical and/or clinical, the education provider must have a process of mapping to demonstrate the curriculum, learning outcomes and assessment strategies of the subject are equivalent to the onshore accredited subject and align with the Australian Qualifications Framework (AQF). The rigor of assessment and timeline for achievement of the related experience should be mapped for equivalence prior to credit being granted for the offshore experience. For the use of an Australian assessment tool in an offshore setting there should be evidence of orientation of host country staff to the tool. If an offshore assessment tool is to be utilised there should be evidence of mapping to Australian assessment tools for equivalence. The education provider must be assured that the host country academic and clinical supervisors are suitably qualified and adequately prepared to support and assess students for their theoretical and clinical learning. For clinical experience undertaken in an offshore setting, the education provider must demonstrate that students will be supervised by a registered nurse or a midwife who has current and relevant experience in the areas of supervision. If supervisory equivalence is unable to be mapped, the education provider should provide an adequately prepared academic staff member to accompany the students. Table 1: Table of amendments Version number Date Short description of amendment V2 May 2013 Amended reference to midwifery programs to include Explanatory Note 4 of 5
all entry to practice midwifery programs. Amended student midwife to midwifery student. V3 May 2015 Added reference to Nurse Practitioner programs Added reference to a formal process of modification for existing accredited programs Added list of relevant documentation Added list of relevant research Added reference to Midwife Accreditation Standards (2014) Added reference to the yet to be reviewed Enrolled Nurse Accreditation Standards (2009) Added requirement of Registered Nurse and Midwife Standards regarding workplace practice towards the end of the program Amended requirement for mapping to Australian assessment tools for equivalence V4 December 2017 Removed reference to offshore components for Enrolled Nurse programs of study. The 2017 Enrolled Nurse Accreditation Standards stipulate that all components of such programs must be conducted within Australia. Date of ANMAC Standards, Accreditation and Assessment Committee Determination 11 February 2013 Date of Review 1 December 2015 Date for Review 1 December 2018 Responsible Director Director of Accreditation Services Explanatory Note 5 of 5